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Published on: June 9, 2018
Transaldolase deficiency - natural disease course towards adulthood
Viktoria Bea Horvath1, Konstantinos Tsiakas2, Heiko Brennenstuhl3
1Heidelberg University, Medical Faculty Heidelberg, Center for Pediatric and Adolescent Medicine, Department I, Im Neuenheimer Feld 430, Heidelberg 69120, Germany.
Transaldolase deficiency, a rare metabolic disorder, can present mildly in adults despite early symptoms. Early diagnosis and monitoring are crucial for managing progressive liver, kidney, and endocrine issues.
Area of Science:
- Biochemistry
- Genetics
- Metabolic Disorders
Background:
- Transaldolase deficiency is a rare inherited metabolic disease linked to the TALDO1 gene.
- Transaldolase is vital for ribose-5-phosphate production, supporting lipid biosynthesis and cellular redox balance.
- Previous reports primarily focused on pediatric cases with diverse and severe phenotypes.
Purpose of the Study:
- To investigate the clinical progression of transaldolase deficiency in adolescents and adults.
- To describe the long-term outcomes and diagnostic challenges in adult patients.
- To compare new adult cases with existing literature data.
Main Methods:
- Case report of three adult patients with genetically confirmed transaldolase deficiency.
- Detailed clinical evaluation including symptoms since birth and diagnostic timelines.
- Literature review and comparison with 47 previously reported cases.
Main Results:
- Three adult patients diagnosed in adolescence/adulthood despite neonatal onset of hepatomegaly and cytopenias.
- Adult phenotype characterized by hypergonadotropic hypogonadism, osteopenia, and renal/hepatic involvement.
- Analysis of two novel TALDO1 variants did not explain a milder disease course.
Conclusions:
- Transaldolase deficiency can have a relatively mild, gradually progressing phenotype in adulthood, even with neonatal onset.
- Patients with unexplained progressive liver disease, kidney dysfunction, cytopenia, and hypergonadotropic hypogonadism should be evaluated for transaldolase deficiency.
- Close monitoring for renal, hepatic, endocrine, and bone complications is recommended for diagnosed patients.
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